𝘍𝘶𝘭𝘭 𝘵𝘩𝘪𝘤𝘬𝘯𝘦𝘴𝘴 𝘔𝘢𝘤𝘶𝘭𝘢𝘳 𝘏𝘰𝘭𝘦 ● Round retinal break involving all the layers of the retina at the fovea, more common in females 𝘊𝘢𝘶𝘴𝘦𝘴: ● Idiopathic ● Pathological Myopia ● Blunt ocular trauma ● Ocular inflammation ● Cystoid macular edema etc 𝘊𝘭𝘪𝘯𝘪𝘤𝘢𝘭 𝘧𝘦𝘢𝘵𝘶𝘳𝘦𝘴: Loss of central visual acuity, metamorphosia, micropsia
𝘗𝘢𝘵𝘩𝘰𝘨𝘦𝘯𝘦𝘴𝘪𝘴: Tangential and anteroposterior traction of the posterior hyaloid on the parafovea 𝘎𝘢𝘴𝘴 𝘚𝘵𝘢𝘨𝘪𝘯𝘨: Stage 1a : Impending macular hole (Vitreomacular Traction) : Yellow spot Stage 1b : Occult macular hole (VMT) : Yellow ring Stage 2 : Small FTMH < 400 microns in diameter. Persistent vitreofoveolar adhesion. Stage 3 : Full thickness hole > 400 microns with a red base in which yellow white dots are seen. Surrounding grey cuff of subretinal fluid seen. Overlying retinal operculum. Stage 4 : Full size macular hole with complete PVD. The posterior vitreous is completely detached, often suggested by the presence of a Weiss ring.
𝘋𝘪𝘢𝘨𝘯𝘰𝘴𝘪𝘴 𝘢𝘯𝘥 𝘐𝘯𝘷𝘦𝘴𝘵𝘪𝘨𝘢𝘵𝘪𝘰𝘯𝘴: ● Clinical examination through slit lamp biomicroscopy/ indirect ophthalmoscopy. ● Amsler Grid ● 𝘞𝘢𝘵𝘻𝘬𝘦- 𝘈𝘭𝘭𝘦𝘯 𝘛𝘦𝘴𝘵 - Narrow vertical slit beam over the fovea with a 90/78D - Break in the bar of light indicates presence of FTMH ● 𝘓𝘢𝘴𝘦𝘳 𝘢𝘪𝘮𝘪𝘯𝘨 𝘣𝘦𝘢𝘮 𝘛𝘦𝘴𝘵 - 50 micron laser beam within lesion- patients with FTMH cannot detect it within the lesion but can detect it when placed in the surroundings ● 𝘖𝘱𝘵𝘪𝘤𝘢𝘭 𝘊𝘰𝘩𝘦𝘳𝘦𝘯𝘤𝘦 𝘛𝘰𝘮𝘰𝘨𝘳𝘢𝘱𝘩𝘺 For diagnosis and staging, prognosis ● FFA - Early hyperfluorescence (window defect) 𝘔𝘢𝘯𝘢𝘨𝘦𝘮𝘦𝘯𝘵: ● Observation (50% of stage 1 holes resolve spontaneously) ● Pharmacological vitreolysis with ocriplasmin ● Surgery – PPV with ILM peeling and gas tamponade www.ophthalmobytes.com Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency #macula #macularhole #fullthicknessmacularhole #retina #trauma #opticalcoherencetomography